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      <h4 class="scenarios"><a href="implementation.html" class="blue">NwHIN 1.0 Portfolio</a> > <a href="scenarios.html" class="blue">Scenarios</a> > <a href="scenario_phr2.html" class="blue">Reporting Notifiable Diseases and Conditions to a Public Health Agency</a></h4>
      <h1 class="testimonials">Reporting Notifiable Diseases and Conditions to a Public Health Agency</h1>
      <h6>An emergency department clinician treats a patient with a notifiable disease and files and sends a report to a public health agency:</h6>
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        <p><img src="images/scenario_PH2.png" alt="S&amp;I Scenarios" title="A flow diagram illustrating the transfer of a notifiable disease report to a public health agency via Direct. An emergency department clinician diagnoses a patient with salmonellosis and enters the diagnostic information into his EHR. After the visit, the emergency department clinician (in conjunction with the hospital infection control department) sends an electronic report and conclusive test results of this diagnosis to the local public health registry via Direct."/></p></div>
      <p>A patient falls ill and visits an emergency department clinician. The patient is diagnosed with salmonellosis, a highly contagious bacterial infection. The CDC requires all salmonellosis cases be reported to a public health registry in order to track and prevent nationwide epidemics. After the visit, the emergency department clinician (in conjunction with the hospital infection control department) sends an electronic report and conclusive test results of this diagnosis to the local public health registry via Direct.</p>
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         <td width="40" align="left" valign="top"> <img src="images/clipboard_check.png" alt="Meaningful Use Objectives" /> </td>
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         <td valign="middle"><p class="mu"><strong>Meaningful Use Stage 2 Objectives related to public health reporting: </strong>Capability to identify and report specific cases to a specialized registry (other than a cancer registry), except where prohibited, and in accordance with applicable law and practice. <em>(Meaningful Use Menu Set 6 for EPs)</em></p></td></tr></table>
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      <h6>Common workflow steps for this scenario:</h6>
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         <td width="891" valign="middle">After treating the sick patient, the emergency department clinician must file a report to be sent to his local public health registery. To do so, he compiles a report that is structured in accordance with the HL7 2.5.1 Content Structure Specification and the HL7 PHIN Messaging Guide for Syndromic Surveillance: Emergency Department and Urgent Care Data. He then authors a Direct message and attaches the report of notifiable disease.</td>
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         <td width="40" align="left" valign="top"> <img src="images/scenario_2.png" alt="2" /> </td>
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         <td width="891" valign="middle">When the emergency department clinician sends the message, it passes through the office&rsquo;s HISP, a contracted brokering agent responsible for the management of security and transport for directed exchange. As it passes through the HISP, the message is encrypted using the x.509 Certificate associated with the recipient, and is delivered to the public health agency&rsquo;s Direct address in accordance with the Applicability Statement for Secure Health Transport.</td>
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         <td width="40" align="left" valign="top"><img src="images/scenario_3.png" alt="3" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">The public health agency&rsquo;s HISP decrypts the message and routes it to the agency&rsquo;s Direct inbox.</td>
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         <td width="891" valign="middle">The public health agency then accesses the Direct inbox and files the notifiable disease report in accordance with legal standards and best practices.</td>
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      <h6>NwHIN 1.0 specifications and resources recommended for scenario:</h6>
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              <h4 class="scenario2"> Content Structure</h4>
              Guidance that specifies how to structure health information to ensure proper exchange</td>
            <td width="587" align="left" valign="middle" bgcolor="#E6E6E6"><ul>
              <li><a href="http://www.cdc.gov/phin/library/guides/Syndromic_Surveillance_Implementation_Guide_Release_1_4.pdf">PHIN Messaging Guide for Syndromic Surveillance: Emergency Department and Urgent Care Data HL7 Version 2.5.1</a></li>
              <li><a href="http://wiki.siframework.org/file/view/V251_IG_SIF_LABRESULTS_R1_N1_v15_Pilot_Use_Only.pdf" target="_new">HL7 v.2.5.1 Laboratory Results Interface Implementation Guide</a></li></ul></td>
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            <td width="299" align="left" valign="top" bgcolor="#BF311A"><h4 class="scenario2">Transport and Security</h4>
              Mechanisms and processes that safely exchange health information over the Internet</td>
            <td align="left" valign="middle" bgcolor="#E6E6E6"><ul>
              <li><a href="http://wiki.directproject.org/Applicability+Statement+for+Secure+Health+Transport">Applicability Statement for Secure Health Transport</a></li>
              <li><a href="http://tools.ietf.org/html/rfc5280" target="_new">x.509 for Certificates</a></li>
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